A Breath of Relief

A Breath of Relief

Story by Michael Hingston | Photos by John Ulan

Karen Hamilton was the first person in the world to receive a lung transplant using groundbreaking new technology. It did more than save her life; it gave her the chance to live fully

Some landmarks of childhood are universal: birthdays, good report cards, losing the first tooth. But from a young age, Karen Hamilton has been keenly aware of another, more ominous, series of milestones — ones caused by the cystic fibrosis with which she was diagnosed as an infant.

As the disease slowly filled her lungs with mucus, the number of things Hamilton was able to do steadily dwindled. One day in junior high, for instance, the Taber, Alta., native woke up and realized that she could no longer play soccer with her friends at school. She found herself out of breath. She tired easily. And she had to cough, constantly, which only damaged her lungs further.

“I knew my whole life that [my condition] was very severe, that I could potentially die early, and that I would need a lung transplant one day,” Hamilton says.

Despite some scary long-term projections — half of all patients who died of cystic fibrosis in 2013 were under the age of 35, according to Cystic Fibrosis Canada — Hamilton’s doctors always encouraged her to lead a normal life and to not let her disease limit her. She attended the University of Lethbridge, got married and became a certified accountant. But even her career path was informed by her medical history. “I was always told, even at a young age, ‘You’re going to need a job with good disability benefits.’ ”

It wasn’t until the arrival of her children, however, that things took a more serious turn. Twins Emma and Lily were delivered via a surrogate more than three months prematurely. The stress of having her infant daughters in the neonatal intensive care unit proved too much for Hamilton, who was already easily fatigued. She suffered a large lung bleed and ended up in hospital alongside them, feeling drained and helpless. After years of trying not to think about it, it was time to seriously consider transplant surgery.

Hamilton was lucky. On Christmas Eve 2013, after being on the wait list for just three months, she got the call that a plane would transport her from her home in Taber to Edmonton within the hour. Still, she felt nervous. Organ transplants are complex, and Hamilton knew there was a good chance her surgery would end up being called off at the last minute due to any number of possible complications ranging from potential damage to the organ to the distance it had to travel for transplant.

In fact, that’s exactly what happened to the woman who flew alongside her, seeking the same donor’s liver. When Hamilton and her husband saw the woman wheeled back out, unsuccessful, she started to pray. “I don’t want to go home and do this all again,” Hamilton remembers saying, unsure she would have the strength to keep fighting after getting her hopes up so high. That’s when a surgeon walked into the room and told her she’d be going in for her lung transplant surgery in 10 minutes.

Hamilton’s donor died of a pulmonary embolism, which meant that blood clots had worked their way into the lungs. Ordinarily, this renders the organs unusable — as are a staggering 70 per cent of all donated organs. But thanks to the Alberta Transplant Institute, part of the University of Alberta’s Faculty of Medicine & Dentistry, Hamilton’s surgeons, Jayan Nagendran and Darren Freed (who are ATI members), had access to the institute’s state-of-the-art ex vivo lung perfusion machine, which is, remarkably, able to repair damaged lungs outside of the body. Typically donated lungs are transported and preserved on ice until transplantation. By contrast, the ex vivo device maintains the lungs at a normal body temperature while continuously infusing them with a bloodless solution of oxygen, proteins and nutrients. This revolutionary process makes the organs more suitable for transplant, vastly increasing the number of lungs available to patients who need them. Hamilton’s transplantation, which used a clot-busting drug on the ex vivo machine to repair her donated lungs, is a first in the world using this portable device.

The Alberta Transplant Institute was founded in 2011 as a way for the constellation of scientists, physicians and educators involved in transplantation in Alberta to work together more easily. Organ transplants have always required input from multiple disciplines, says Lori West, director of ATI, but the institute’s link to the university allows it to “sit right at that critical interface between health-care delivery and research and education.” Donations to the ATI allow West and her colleagues to continue investing in cutting-edge systems such as the ex vivo machine (a liver-repairing version of which saved the life of a patient battling liver cancer in 2015 — a first in North America), as well as using their results to convince the health-care system to adopt these newer technologies faster.

As for Karen Hamilton, who has spent much of her life scouring parking lots for the spot closest to the door, when she takes her three-year-old twins to the grocery store today: “I can park in the farthest [spot] away. And I gladly walk.”

Bringing together more than 100 researchers, experts and thought leaders into a comprehensive multi-organ transplant program, the Alberta Transplant Institute is one of the most advanced transplant research and training centres in Canada and the only one serving Western Canada.

To learn how to help the ATI give thousands of people living with organ failure a second chance at life, contact Matthew Burns at 780-492-9605 or matthew.burns@ualberta.ca.